UCHICAGO Guest Travel Airline Ticket Request Authorization

This form allows for reservation of airfare by Tower Travel.

Complete this form, print, sign, scan, and email the document as an attachment to Tower Travel. When Tower Travel receives the authorization, Tower will send a confirmation email notification to your attention. Thereafter, your Guest Traveler is to contact Tower Travel at 1-866-625-6491 or 1-630-928-7148, or via email at [email protected], 8:00am to 5:00pm CT Monday through Friday. At the time of booking, your Traveler is to mention that a completed Guest Traveler Request Authorization is on file.

Email to: [email protected] GUEST TRAVELER INFORMATION

Guest Last Name: First Name: Middle Initial: Telephone Number: Mobile Number: Email Address: Travel Departure Date: Destination City Name: Additional Comments:

UNIVERSITY HOST/COORDINATOR INFORMATION

University Host/Coordinator Name: Email Address: University Telephone Number: Department Name: Four Digit Department Code: Identify University Email Address to Send the Invoice and Itinerary to: Phone Number for Agent to Call to Receive Form of Payment Information (card holder name and account number):

Do You Allow the Guest Traveler to Make Changes to the Travel Itinerary Once the Reservation is Booked: Yes No

Do You Authorize Payment of Any Applicable Airline Change Fees: Yes No

Identify Airfare Class of Service to be Booked: Economy Business Class First Class

Identify the Airfare Dollar Cap (do not allow Guest Traveler to book over following dollar amount): $

I authorize Tower Travel to charge the airfare on the GEMS credit card of the cardholder listed above.

Signature